Hepatitis A epidemic infects thousands

2008-12-10

By Monika Hanley

RIGA - A hepatitis A epidemic, the worst in 20 years, has swept the nation with almost 2,000 patients being treated so far this year. On Nov. 28 alone, 13 patients were admitted to the hospital for treatment.The head of the Infectious Diseases Center of Latvia, Baiba Rozentale, told The Baltic Times that "it is likely to continue to spread in Latvia next year as people lack special immunity to this virus." The Latvian Infectious Diseases Center had said earlier that hepatitis A was likely to keep spreading with no easy solution in sight. Vaccinations against the virus are not mandatory, nor are they partially funded by the government as is the case with other disease inoculations.

"A whole generation that has not been vaccinated against this form of hepatitis has grown up, and the disease has found a fertile soil," said the head of the Infectious Diseases Center. The outbreak began at the end of 2007, with the disease mainly affecting people aged 18 to 39.The Public Health Agency reported that last year there were 15 people registered with hepatitis A, while the last epidemic took place in 1995 with 2,543 hepatitis A patients registered.Currently there are 149 jaundice patients being treated in the hospital, and 1,554 patients have been released from the hospital, reported the Latvian Infectious Diseases Center.The actual number of jaundiced patients is larger 's the total number is not as closely monitored because many have the disease in a light form and can be treated at home.

In the span of one month, from September to October, the number of confirmed cases of hepatitis A reached 257, with 265 cases under investigation by the Infectious Diseases Center. Many cases were associated with contaminated food products."In Latvia the problem really started with food, especially the incident in the cafe in Old Town: that was the beginning. The next group of infected people was drug users. After that it spread to the general population," Laura Budele of the Health Ministry told TBT. Currently the disease is contained to Riga city and minor outlying areas, but has yet to go further than city limits."So far the most affected region has been Riga and the surrounding Riga region, but it's possible that in the next year hepatitis A may spread out of the city," said Budele.

Stemming the SpreadCurrently the Health Ministry is focusing on awareness more than prevention, while regional governments are able to do a bit more. "Regional governments are more active and are able to provide vaccinations for kindergarteners at no cost, whereas the national government cannot guarantee vaccinations," explained Budele. Degpunkta nightly news program reported that hepatitis can be found in many more surfaces than just food. "You have to be careful to wash everything, hands, plastic bags from the grocery store, anything that people could have touched needs to be washed to prevent the spread," Degpunkta said.Experts expect incidences of hepatitis A might decline with the cold weather coming, though it is not expected to go away anytime soon.

"Hepatitis A comes in waves that last 2-3 years. What is going on now is normal but it probably will not get better in the near future," said Budele. The problem is similar to current Hepatitis outbreaks in Europe, most notably in the Czech Republic. "Our colleagues in Prague have said that the spread from food, to drug users to youth occurred there, so we're seeing this as a normal pattern," reported Budele The government is currently doing its best to educate and bring awareness to the problem. "We are using a two part system to educate and control the spread of the disease, so everyone is aware of correct hygiene practices, especially in schools," said Budele.

An analysis of the 2008 outbreak was conducted by Eurosurveillance, which found that of the hundreds of cases in the past year, 11 cases were linked to schools, 9 cases linked to prisoners and 47 cases linked to a restaurant outbreak. As the economy worsens and unemployment grows, it is possible that the epidemic will worsen. The cases observed by Eurosurveillance involved a high proportion of unemployed people among adult cases (45 percent).

Research also implied that low income and possibly bad living conditions contribute to the spread 's clusters of cases were registered in low-income housing areas.Eurosurveillence also reported that intravenous drug users were affected at the beginning of the outbreak (35 percent), showing that perhaps they were at the root of the problem. Currently Latvia is seeing the outbreak at its peak so far this year. Adding to the numbers were the infamous Stella Pub victims, 47 customers who ate contaminated food in May. Court proceedings against the restaurant are still ongoing in an effort to help victims gain much needed funds after being in the hospital for extended amounts of time.

Though it is not usually fatal, the disease has already killed five people this year, the disease center reported.

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